# Breaking the stigma: the role of family support in hepatitis B management from a public health education perspective

## TL;DR

This paper explores how family support and healthcare systems can help reduce stigma and improve outcomes for people living with hepatitis B.

## Contribution

It introduces a dynamic, multilevel framework linking family support, stigma, and institutional healthcare strategies in hepatitis B management.

## Key findings

- Stigma disrupts family support and treatment engagement for individuals with hepatitis B.
- Healthcare institutions can reduce stigma through structured communication and relational strategies.
- Family-centered and nursing-integrated approaches are essential for sustainable stigma reduction.

## Abstract

Hepatitis B remains a major global public health challenge. Beyond its clinical burden, hepatitis B-related stigma persists as a multilevel social process embedded within relational and institutional structures. Despite advances in vaccination and antiviral therapy, individuals living with hepatitis B continue to experience psychological distress and social marginalization shaped by stigma. Family systems represent a central relational context in which infection identity is interpreted and negotiated. Through disclosure practices, identity organization, and responses to institutional pressures, families regulate the visibility and salience of infection identity. At the same time, stigma may disrupt these processes, weaken support structures, and undermine psychological well-being and treatment engagement. This narrative review reconceptualizes the interaction between family support and hepatitis B–related stigma as a dynamic pathway operating across individual, familial, and structural levels. It highlights how healthcare institutions—particularly nursing systems embedded in long-term disease management—can modulate stigma through structured communication, relational repositioning, and institutional risk navigation. These findings underscore the need for family-centered, nursing-integrated, and public health–aligned strategies that address stigma beyond individual cognition. Such an approach provides a structured foundation for sustainable stigma reduction and equity-oriented support for people living with hepatitis B.